Dr. Lawrence Choy, 65, is charged with 231 counts ranging from manslaughter to the criminal sale of prescriptions. He was extradited back to NY earlier this week.
Three of these patients ultimately died of prescription drug overdoses between 2013 and 2016.
"After 30-plus years in law enforcement I never thought I'd see the day where doctors and drug dealers were interchangeable", James Hunt, the special agent in charge of the Drug Enforcement Administration in NY, said in announcing the charges.
Choy is being charged with second degree manslaughter in connection with their deaths.
Choy was arrested in March in Wisconsin and extradited to NY. Choy is accused if causing the overdose deaths of 35-year-old Eliot Castillo and 30-year-old Michael Ries, who each fatally overdosed within three days of receiving prescriptions from Choy.
A third patient, Daniel Barry, 43 also died of an overdose, according to authorities.
He was determined by the medical examiners to have overdosed on "the holy trinity" of medications - oxycodone, alprazolam, and carisoprodol. Brennan said Choy then shifted into pain management and began issuing large numbers of prescriptions to patients, some of whom had genuine pain issues. A licensed physician since 1981, Choy specialized in internal medicine and nephrology (the treatment of diseased kidneys) and operated a full-time medical office at 142-20 Franklin Avenue in Flushing.
Law enforcement sources say Choy turned to peddling pills after the IRS and New York State issued warrants alleging he owed $1 million in back taxes. Authorities say they became suspicious when they spotted a high volume of prescriptions for patients from as far away as Pennsylvania and New Jersey.
Judge Neil Ross ordered Choy held without bail but indicated he could be released later on Thursday if a bail package was arranged, officials said. The criminal investigation was triggered when the Pennsylvania Attorney General's Office became aware that suspicious prescriptions issued in Choy's name were being filled at pharmacies in that state and then contacted law enforcement partners in NY.
"All three drugs have the effect of suppressing respiration and heartbeat, when take together, the risk overdose death is much higher", Brennan said.
Carisoprodol is a muscle relaxant which is also known as Soma.
The investigation showed that Choy, "personally observed the patients' physical and mental states deteriorate, while disregarding reports about patients' involvement in accidents, including motor vehicle accidents", the DEA said.